Does the measurement of four fetal arteries provide more information than the measurement of just two arteries in prenatal Doppler sonography?

Objective: The objective of this study was to evaluate whether the measurement of two or more fetal arteries provides more information and leads to a selection of fetuses at higher risk.

Design: In 244 pregnancies Doppler examinations in four fetal arteries (fetal aorta, common carotid artery, middle cerebral artery, umbilical artery) were performed. The evaluation of the results was made by means of a Doppler score for standardization and systematization. The results were divided into four groups (normal, pre-pathological, pathological, highly pathological) and the individual correlations with fetal outcome parameters were investigated. The results from measuring only two fetal arteries (the fetal aorta and middle cerebral artery) were then compared with those from all four arteries.

Results: Increasing pathology of the Doppler score correlated with fetal outcome parameters. The results showed that if the Doppler result in the two-vessel measurement was normal (n = 180), pre-pathological (n = 29) or highly pathological (n = 12) then measuring four vessels generally brought no additional information. However, the four-vessel measurement was of advantage in the pathological group (n = 23) because it selected the high-risk fetuses (30.4%), as categorized by outcome.

Conclusions: Differentiating between several degrees of pathology is important for the estimation of fetal risk. In cases of pathological Doppler findings, the measurement of more than two vessels is important in order to select fetuses at increased risk.